Children's Hospital Capital Institute of Pediatrics, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Beijing Tsinghua Changgung Hospital, Beijing, China.
Pediatr Surg Int. 2023 Feb 8;39(1):105. doi: 10.1007/s00383-023-05374-5.
This study aimed to evaluate the effect of prenatal diagnosis at different gestational times on the clinical features of patients with choledochal cysts (CDCs).
Medical records of patients with prenatally diagnosed CDCs admitted to our hospital (April 2013-April 2018) were retrospectively reviewed. The clinical characteristics and pathological CDC features were analyzed.
Two hundred eighteen cases were included. Patients were divided into two groups. Group 1 and group 2 had a prenatal diagnosis at ≤ 27 weeks of gestation (second trimester of gestation, n = 157) and > 27 weeks (third trimester of gestation, n = 61), respectively. The incidence of jaundice and the TBIL, IBIL and GGT levels were higher in Group 1 (P = 0.021, P = 0.029, P = 0.042, P = 0.007, respectively). The maximum cyst diameter at the time of surgery was larger in Group 1 (P = 0.015). An association study showed that the time of prenatal diagnosis was negatively correlated with the maximum cyst diameter both postnatally (r = - 0.223, P = 0.001) and at the time of surgery (r = - 0.268, P < 0.001).
Unlike patients diagnosed at a late prenatal age, patients diagnosed at an early prenatal age tend to present clinical symptoms (jaundice, manifested as high indirect bilirubin), hepatic function damage, and large cysts at the time of surgery.
本研究旨在评估不同孕期产前诊断对先天性胆总管囊肿(CDC)患者临床特征的影响。
回顾性分析我院(2013 年 4 月至 2018 年 4 月)收治的产前诊断为先天性胆总管囊肿的患者的病历资料,分析其临床特征及病理先天性胆总管囊肿特征。
共纳入 218 例患者。患者分为两组,组 1 和组 2 在妊娠 27 周之前(妊娠中期,n=157)和妊娠 27 周后(妊娠晚期,n=61)进行产前诊断。组 1 患者的黄疸发生率以及 TBIL、IBIL 和 GGT 水平均高于组 2(P=0.021、P=0.029、P=0.042、P=0.007)。组 1 患者的手术时最大囊肿直径较大(P=0.015)。关联研究表明,产前诊断时间与产后(r=-0.223,P=0.001)和手术时(r=-0.268,P<0.001)最大囊肿直径均呈负相关。
与晚期产前诊断患者不同,早期产前诊断的患者在手术时往往表现出临床症状(黄疸,表现为高间接胆红素)、肝功能损害和大囊肿。